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Summer research stories: Finding a surgical fix for spina bifida

Chia-Ying Lin remembers well the moment his interests shifted to bioengineering.

An undergrad at National Taiwan University in the 90s, he was studying to be a civil engineer. Mostly, he’d been learning about building bridges, roads—inanimate structures—when a professor introduced him to orthopedics and got Lin him lined up with an orthopedic surgeon to shadow at a local medical center.

“I was intrigued and fascinated,” Lin says. “Orthopedics is building different types of constructs—but for the human skeleton,” Lin says. “They even use a lot of the same terminology—like, the thing we use to fix joint implants. It’s called bone cement!”

Following the surgeon into clinics, emergency rooms and operating rooms, Lin was struck by all the ways biomedical engineering could possibly improve human health.

Lin dove into the burgeoning field. He moved to the United States to earn a master’s and then a doctorate in biomedical engineering from the University of Michigan. After he finished his Ph.D., U of M tapped Lin to be director of its spine research laboratory. He led the lab for 10 years, until UC came knocking and he took an endowed chair position in biomedical engineering at CEAS in 2014.

The path has led him to the important work he’s doing today in the orthopedics wing of the Medical Sciences Building—work that took a big step this summer.

He and fellow UC researcher Dr. Jose Peiro, a pediatric surgeon and director of endoscopic fetal surgery at Cincinnati Children’s Hospital, are working on a smart patch that would reduce the impact of spina bifida in children.

“Open spina bifida or myelomeningocele is a devastating neurologic congenital defect characterized by primary failure of neural tube closure of the spinal column during the embryologic period,” the project’s abstract explains.

With minimally invasive surgery a pediatric surgeon, like Peiro, can apply a patch to close the column while the fetus is developing. It’s one of the few prenatal surgeries done today, but the current patch is somewhat rigid and cumbersome to insert. It must be surgically removed after the baby is born. These factors create unwanted risk, Lin says, but the patches have been proven to help prevent neurological and physical defects created by spina bifida from forming.

Lin’s patch is “smart” because it has a memory. It is built with a 3-D printer with materials that can change shape and then revert back to an earlier shape. This allows the patch to be coiled for easier and quicker insertion during surgery, before it morphs back into the intended shape for the cap on the tiny spine. Over time, the patch dissolves and is replaced by tissue, making corrective surgery unnecessary.

The smart patch team, which includes Lin’s former biomedical engineering doctoral student Rigwed Tatu and Peiro’s research associate Marc Oria, has established proof of concept and secured funding for a large animal study this summer to test the patch. The work is backed by a $2.3M award from the NIH’s National Institute of Biomedical Imaging and Bioengineering Bioengineering Research Program.

The BRP is the largest funding mechanism at NIHBIB to support development of enabling technologies to help tackle unaddressed biomedical challenges through interdisciplinary endeavors.

Lin could have stuck with bridges—whose structural integrity is certainly important—but building biomedical and biomechanical solutions for infants and children makes Lin feel “useful.”

“Kids are vulnerable,” Lin says. “Many times, you can’t find adequate solutions for them. I’m happy that my unique training and history has helped me cook up some novel ideas to find new approaches to some big hurdles.”